Is adult dental coverage considered an essential health benefit in the individual or small group market?

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Adult dental coverage is not classified as an essential health benefit in the individual or small group market. While the Affordable Care Act (ACA) mandates coverage for essential health benefits, adult dental care does not fall under this requirement. Instead, it is categorized as a beneficial service that can be offered, but it is not mandatory. Thus, individuals and families have the option to purchase dental coverage separately from their health insurance plans if they choose to do so.

This distinction highlights the flexibility within the marketplace, as consumers can tailor their coverage to meet their specific needs without being compelled to include dental services unless they deem it necessary.

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